Few Hospitals Take Steps Needed to Encourage Breast-Feeding

[Guest guest]

Only a small percentage of hospitals in the United States practice the full

range of key strategies that the World Health Organization (WHO) advocates

to support and encourage breast-feeding among new mothers, according to a

new report from the Centers for Disease Control and Prevention published

online<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm60e0802a1.htm?s_cid=mm60e0802a\

1_w>August

2.

Breast-feeding is well known to provide a plethora of important health

benefits to children, including protecting against childhood obesity and

preventing infectious illnesses. However, the report indicates, only 14% of

hospitals have a written, model breast-feeding policy.

In addition, healthy infants are regularly given formula even when it is not

necessary at nearly 80% of hospitals, a practice that significantly hinders

a mother's efforts to learn breast-feeding and to feed her infant solely on

breast milk at home.

Only a third of hospitals practice " rooming in, " in which the baby stays in

the room with the mother, allowing for frequent opportunities to learn

breast-feeding. And nearly 75% of hospitals fail to provide follow-up

support, such as a home visit, a phone call from staff, or referral to

lactation consultants after leaving the hospital.

" Hospitals play a vital role in supporting a mother to be able to

breastfeed, " said CDC Director R. Frieden, MD, MPH, in a press

statement.

" Those first few hours and days that a mom and her baby spend learning to

breastfeed are critical. Hospitals need to better support breastfeeding, as

this is one of the most important things a mother can do for her newborn. "

The findings represent data from the CDC's national survey of Maternity

Practices in Infant Nutrition and Care, part of the WHO and UNICEF's

Baby-Friendly Hospital Initiative. The initiative's core mission is to

advocate " Ten Steps to Successful Breastfeeding " that hospitals should

follow to improve breast-feeding initiation, duration, and exclusivity.

The evidence-based steps, endorsed by the American Academy of Pediatrics,

include the specification that hospitals refrain from giving formula or food

other than breast milk to healthy infants unless there is a medical need for

it.

Hospitals should also encourage mothers to room in and stay in the company

of their infant 24 hours a day, and they should provide new mothers with the

follow-up communication and resources to continue to receive breast-feeding

support after leaving the hospital.

The report, which looked at data from 2007 and 2009, showed that only a tiny

percentage of hospitals — 2.4% — recommended practices covering at least 9

of the 10 steps in 2007, and the figure improved only slightly to 3.5% by

2009.

Most hospitals did provide some breast-feeding support by 2009: 93% had

staff members offer prenatal breast-feeding education, 89% taught mothers

breast-feeding techniques, and 82% taught mothers how to recognize

breast-feeding cues from their newborns.

But the low rate of hospitals that practice the WHO/UNICEF Ten Steps of

Successful Breastfeeding suggests most still fall short in providing new

mothers adequate breast-feeding support, the authors wrote.

" These data illustrate the persistent use of practices that are inconsistent

with best-practice standards and do not support breastfeeding, " they said.

One important reason why hospitals fail to adopt the full range of

recommended breast-feeding strategies is a perception of higher costs;

however, following the steps appropriately should not cost significantly

more, explained study coauthor Cria G. Perrine, PhD, in a CDC press briefing

on Tuesday.

" We do have data that suggests that a baby-friendly hospital is no more than

the cost of the birth in a non baby-friendly hospital, so while there may be

costs associated with becoming baby-friendly, those depend on where they are

and what improvements they need to make, " said Dr. Perrine, an

epidemiologist with the CDC's Division of Nutrition, Physical Activity and

Obesity.

The breast-feeding efforts could in fact lead to reduced expenses in the

long-term, Dr. Frieden added at the press briefing.

" Some hospitals have found that going baby-friendly has not significantly

increased their expenses, and of course, it will substantially reduce health

care expenditures overall, as children are less likely to need to come back

with respiratory infections and diarrhea and ear infections, and mothers are

less likely to get ovarian and breast cancer, " stated Dr. Frieden.

Suboptimal breast-feeding in the United States results in an estimated $2.2

billion in additional direct medical costs annually, according to the

report.

Dr. Frieden also added that hospitals often have relationships with formula

providers that result in new mothers receiving formula for free.

" The formula companies will often provide free formula for the infants who

are premature or otherwise need special formulas, and they do that in

exchange for the hospital promoting formula, basically, by giving formula to

every mother who leaves the hospital, and that deal saves the hospital some

cash in the purchase of the specialty formulas. "

Evidence, meanwhile, indicates that children are much better off with breast

milk alone. One recent meta-analysis showed that children who were

breast-fed for 9 months or more had a more than 30% reduced odds of becoming

overweight, compared with those who were never breast-fed. Also, the risk

for infections and illnesses in children is increased when breast-feeding is

discontinued early, according to the report.

Considering the benefits, hospitals should give breast-feeding support a

higher priority, Dr. Frieden said at the press briefing.

" We're a very long way from where we need to be, " he said. " Currently, only

about 1 in 6 mothers, [that is] 15% of mothers, breastfeed exclusively for 6

months, and less than half of mothers, 44%, breastfeed at all for 6 months.

Seventy-five percent of women start breastfeeding in the hospital, but many

barriers are presented that make it less likely that women who want to

breastfeed will do so, " he added.

" In fact, less than 1 out of 20 babies born in the US in this year is born

in a hospital that meets the baby-friendly guidelines of the World Health

Organization and UNICEF. "

*MMWR Morb Mortal Wkly Rep*. Published

online<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm60e0802a1.htm?s_cid=mm60e0802a\

1_w>August

2, 2011.

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

Join me on Facebook <http://www.facebook.com/TheFrugalDietitian?ref=ts>

* " Nutrition is a Science, Not an Opinion Survey " *

36M lbs. of turkey recalled in salmonella

outbreak<http://thefrugaldietitian.com/?p=24635>